Prognostic value of tumour volume in patients with a poor Karnofsky performance status scale - a bicentric retrospective study.

Backround: Median overall survival (OS) after diagnosis of glioblastoma (GBM) remains 15 months amongst patients receiving aggressive surgical resection, chemotherapy and irradiation. Treatment of patients with a poor preoperative Karnofsky Performance Status Scale (KPSS) is still controversial. Therefore, we retrospectively assessed the outcome after surgical treatment in patients with a KPSS of ≤60%.

How I do it: retrosigmoid suprajugular approach to the jugular foramen.

Background: The retrosigmoid suprajugular approach provides a less-aggressive approach for a subset of tumors of the jugular foramen.

Method: We described the retrosigmoid suprajugular approach with its advantages, caveats, and indications. A Samii-B2 glossopharyngeal nerve schwannoma is shown to exemplify the procedure.

Retrospective distortion correction of diffusion tensor imaging data by semi-elastic image fusion - Evaluation by means of anatomical landmarks.

Objective: Diffusion tensor imaging (DTI) based on echo-planar imaging (EPI) can suffer from geometric image distortions in comparison to conventional anatomical magnetic resonance imaging (MRI). Therefore, DTI-derived information, such as fiber tractography (FT) used for treatment planning of brain tumors, might be associated with spatial inaccuracies when linearly projected on anatomical MRI. Hence, a non-linear, semi-elastic image fusion shall be evaluated in this study that aims at correcting for image distortions in DTI.

Correction to: Prognostic Value of Tumor Volume in Glioblastoma Patients: Size Also Matters for Patients with Incomplete Resection.

Due to a metadata tagging error the names of Stephanie E. Combs and Jan S. Kirschke were indexed incorrectly.

Retrospective Analysis of Radiological Recurrence Patterns in Glioblastoma, Their Prognostic Value And Association to Postoperative Infarct Volume.

Recent studies suggested that postoperative hypoxia might trigger invasive tumor growth, resulting in diffuse/multifocal recurrence patterns. Aim of this study was to analyze distinct recurrence patterns and their association to postoperative infarct volume and outcome. 526 consecutive glioblastoma patients were analyzed, of which 129 met our inclusion criteria: initial tumor diagnosis, surgery, postoperative diffusion-weighted imaging and tumor recurrence during follow-up.

Is Eighty the New Sixty? Outcomes and Complications after Lumbar Decompression Surgery in Elderly Patients over 80 Years of Age.

Objective: An increasing demographic aging of the general population results in a rising incidence of octogenarians and nonagenarians with spine disease. Patients older than 65 years represent the majority of patients with degenerative lumbar spine disease in our daily clinical routine. Surgical treatment is undertaken reluctantly because of an increased rate of comorbidities.

Prognostic Value of Tumor Volume in Glioblastoma Patients: Size Also Matters for Patients with Incomplete Resection.

Background: Incomplete resection of glioblastoma is discussed controversially in the era of combined radiochemotherapy.

Objective: The aim of this study was to analyze the benefit of subtotal tumor resection for glioblastoma patients as this was recently questioned in the era of radiochemotherapy.

Methods: Overall, 209 patients undergoing surgery for newly diagnosed WHO grade IV gliomas were retrospectively analyzed, and pre- and postoperative tumor volumes were manually segmented (cm).

Re-irradiation after gross total resection of recurrent glioblastoma : Spatial pattern of recurrence and a review of the literature as a basis for target volume definition.

Background: Currently, patients with gross total resection (GTR) of recurrent glioblastoma (rGBM) undergo adjuvant chemotherapy or are followed up until progression. Re-irradiation, as one of the most effective treatments in macroscopic rGBM, is withheld in this situation, as uncertainties about the pattern of re-recurrence, the target volume, and also the efficacy of early re-irradiation after GTR exist.

Methods: Imaging and clinical data from 26 consecutive patients with GTR of rGBM were analyzed.

L5 corpectomy-the lumbosacral segmental geometry and clinical outcome-a consecutive series of 14 patients and review of the literature.

Purpose: We analyzed the lumbosacral segmental geometry and clinical outcome in patients undergoing L5 corpectomy.

Methods: Fourteen consecutive patients who underwent L5 (n = 12) or L4 + 5 (n = 2) corpectomy at our department between January 2010 and April 2015 were included. All patients underwent a baseline physical and neurologic examination on admission.

Risk of cement leakage and pulmonary embolism by bone cement-augmented pedicle screw fixation of the thoracolumbar spine.

Background: Cement-augmented pedicle screw instrumentation (CAPSI) of the thoracolumbar spine is indicated in osteoporosis or osteopenia to improve pullout strength and biomechanical stability of pedicle screws (PS). Only a few studies report on the incidence of pulmonary cement embolism or other complications associated with CAPSI.

Purpose: The aim of this retrospective study was to assess the rate of CAPSI-associated complications.

Infarct volume after glioblastoma surgery as an independent prognostic factor.

Postoperative ischemia is associated with reduced functional independence measured by karnofsky performance score (KPS), which correlates well with overall survival. Other studies suggest that postoperative hypoxia might initiate infiltrative tumor growth. Therefore, aim of this study was to analyze the impact of infarct volume on overall survival and progression free survival (PFS) of glioblastoma patients.

Fractional Anisotropy Correlates with Overall Survival in Glioblastoma.

Objective: Glioblastoma (GB) is an infiltrative disease that results in microstructural damage on a cellular level. Fractional anisotropy (FA) is an important estimate of diffusion tensor imaging (DTI) that can be used to assess microstructural integrity. The aim of this study was to examine the correlation between FA values and overall survival (OS) in patients with GB.

Treatment strategy for cerebral hypotension caused by spontaneous cerebrospinal fluid leaks.

Objective: Spontaneous spinal cerebrospinal fluid (CSF) leaks are rare (5 per 100,000 per year). Treatment generally consists of conservative therapy or interventional therapy with epidural blood patching. Surgical treatment is conducted rarely, usually in cases when conservative or interventional treatment has failed.

Risks of postoperative paresis in motor eloquently and non-eloquently located brain metastases.

Background: When treating cerebral metastases all involved multidisciplinary oncological specialists have to cooperate closely to provide the best care for these patients. For the resection of brain metastasis several studies reported a considerable risk of new postoperative paresis. Pre- and perioperative chemotherapy (Ctx) or radiotherapy (Rtx) alter vasculature and adjacent fiber tracts on the one hand, and many patients already present with paresis prior to surgery on the other hand.

Postoperative ischemic changes following brain metastasis resection as measured by diffusion-weighted magnetic resonance imaging.

Object: Brain metastases occur in 10% to 40% of patients harboring cancer. In cases of neurosurgical metastasis resection, all postoperative neurological deterioration should be avoided. Reasons for postoperative deficits can be direct tissue damage due to resection, hemorrhage, venous congestive infarcts, or arterial ischemic events leading to tissue infarction.